Why care about integrated care? Part I. Demographics, finances and workforce: immovable objects facing mental health services

2020 ◽  
pp. 1-11
Author(s):  
Derek K. Tracy ◽  
Frank Holloway ◽  
Kara Hanson ◽  
Adrian James ◽  
Geraldine Strathdee ◽  
...  
Keyword(s):  
Mental Health ◽  
Integrated Care ◽  
Public Service ◽  
Social Care ◽  
Financial Resources ◽  
The Public ◽  
Health And Social Care ◽  
Care Systems ◽  
Changing Demographics

SUMMARY Demands on health and social care are growing in quantity and complexity, with resources and staffing not projected to match this. The landmark NHS Long Term Plan calls for services in England to be delivered differently through integrated care systems (ICSs) that will better join commissioners and providers, and health and social care. The scale of these changes is immense, and the detail can feel confusing. However, they are important and will affect all clinicians in the public service. This three-part series provides a primer on integrated care, explaining why it is happening, how services are changing and why clinicians should get involved. In this first article we focus on the changing demographics, and the workforce and financial resources required to address these.

scholarly journals Háziorvosok és idősellátás egy kérdőíves kutatás tükrében

2018 ◽  
Vol 159 (8) ◽  
pp. 312-319
Author(s):  
Anett Mária Tróbert ◽  
Zsuzsanna Széman
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Social Care ◽  
The Elderly ◽  
Care Process ◽  
Efficient Operation ◽  
Health And Social Care ◽  
Care Systems ◽  
Care System

Abstract: According to statistical data, the number of healthy life years is not increasing in proportion with the longer average life expectancy. In the ageing societies, the long-term care systems are increasingly overburdened; cost-efficient operation and the related coordination of services is one of the key questions for their sustainability. The present separation of the health care and social care systems causes numerous difficulties. One aim of the online research by questionnaire was to survey the attitude of general practitioners – who play a very important part in care for the elderly – towards their elder patients, the patients’ family members, and social workers providing eldercare. The other aim was to gather information on shortcomings experienced by doctors in the care system and on what possibilities general practitioners see for the improvement of eldercare. Semi-structured questionnaires were applied and analysed by descriptive and content methodology. The questionnaires were sent out to 5060 addresses around the country: a total of 145 were returned filled in. The respondents made many recommendations for the improvement of eldercare in the categories of development of social services, family support, development of health services, and societal cooperation. The areas in need of development named by the general practitioners are closely interrelated: the reform of social care would support the health care system and vice versa. More effective operation of the health and social care systems would ease the burdens of families, and at the same time encourage more active participation of families in the care process. And the systematic education of society and communities is a long-term investment that would strengthen a positive attitude towards old age and a value-oriented view of the ageing process that is one of the basic conditions for successful social integration of the elderly. Orv Hetil. 2018; 159(8): 312–319.

scholarly journals Participatory approach in developing the long-term care strategy in Slovakia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Katreniakova ◽  
M Levyova ◽  
M Giertl ◽  
I Nagyova
Keyword(s):  
Online Survey ◽  
Long Term Care ◽  
Social Care ◽  
Slovak Republic ◽  
Participatory Approach ◽  
Term Care ◽  
Starting Point ◽  
Health And Social Care ◽  
Care Systems

Abstract Issue/problem In Slovak Republic (SR) old-age dependency will rise rapidly in the near future and will more than double in the next 15 years. This profound demographic changes will require restructuring of health and social care systems with more people working in the long-term care (LTC) sector and most likely a higher level of public spending to cover the growing LTC needs. Description of the problem Providing LTC in Slovakia has many problem areas. It is governed by several acts and regulations, which are not always linked and sometimes do not cover the situation entirely. There is not coordinated and integrated LTC model implemented and the distribution of the roles between the health and social care systems is lacking. Results Since 2017 a policy dialog between the key stakeholders - the Ministry of Health of the SR; the Ministry of Labour, Social Affairs and Family of the SR; and civic societies led by the Association for the Patients’ Rights Protection has been in place with aim to improve the current LTC Strategy Proposal. Online survey was carried out in May - June 2018, which brought deeper insights into the needs regarding demand and supply, and uncovered the main limitations of the current LTC system, e.g. insufficient capacity of LTC beds or a malfunctioning information system. This was followed by six workshops for professional and lay public, organised between February and March 2019 with aim to collect further evidence on regional level. Lessons The LTC Strategy Proposal development is one of 12 pilot projects within the national project - Promoting partnership and dialogue on participatory public policy making in SR. The initiative takes into account the needs and demands of LTC target groups and will serve as a starting point for further action in this area. [Grant Support: APVV-15-0719]. Key messages In Slovakia, a complex solution of long-term care issues is essential. Developing the LTC Strategy Proposal through participatory approach is an important starting point for future action.

scholarly journals Integrated care in mental health: next steps after the NHS Long Term Plan

2019 ◽  
Vol 214 (06) ◽  
pp. 315-317 ◽  
Author(s):  
Derek K. Tracy ◽  
Kara Hanson ◽  
Tom Brown ◽  
Adrian J. B. James ◽  
Holly Paulsen ◽  
...  
Keyword(s):  
Integrated Care ◽  
Royal College ◽  
Ageing Population ◽  
Select Committee ◽  
Complex Needs ◽  
Health And Social Care ◽  
Care Systems ◽  
The Uk

SummaryHealth and social care face growing and conflicting pressures: mounting complex needs of an ageing population, restricted funding and a workforce recruitment and retention crisis. In response, in the UK the NHS Long Term Plan promises increased investment and an emphasis on better ‘integrated’ care. We describe key aspects of integration that need addressing.Declaration of interestD.K.T. and S.S.S. are on the editorial board of the British Journal of Psychiatry and executives of the Academic Faculty at the Royal College of Psychiatrists. A.J.B.J., H.P. and Z.M. have roles at the Royal College of Psychiatrists that include evaluation of integrated care systems. A.J.B.J. is married to Dr Sarah Wollaston, Member of Parliament for Totnes and Chair of the Health Select Committee.

Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Derek K. Tracy ◽  
Frank Holloway ◽  
Kara Hanson ◽  
Nikita Kanani ◽  
Matthew Trainer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Integrated Care ◽  
Healthcare Delivery ◽  
Local Implementation ◽  
The Past ◽  
Care Systems

SUMMARY Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.

scholarly journals International experiments with different models of allocating funds to facilitate integrated care: a scoping review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021374
Author(s):  
Akram Khayatzadeh-Mahani ◽  
Ellen Nolte ◽  
Jason Sutherland ◽  
Pierre-Gerlier Forest
Keyword(s):  
Integrated Care ◽  
Scoping Review ◽  
Care Coordination ◽  
Social Care ◽  
Service Providers ◽  
Research Question ◽  
Major Barrier ◽  
Health And Social Care ◽  
Wide Range ◽  
Care Systems

IntroductionIntegrated care is viewed widely as a potential solution to some of the major challenges faced by health and social care systems, such as those posed by service duplication, fragmentation and poor care coordination, and associated impacts on the quality and cost of services. Fragmented models of allocating funds to and across sectors, programmes and providers are frequently cited as a major barrier to integration and countries have experimented with different models of allocating funds to enhance care coordination among service providers and to reduce ineffective care and avoid costly adverse events. This scoping review aims to assess published international experiences of different models of allocating funds to facilitate integration and the evidence on their impacts.Methods and analysisWe will adopt a scoping review methodology due to the potentially vast and multidisciplinary nature of the literature on different models of allocating funds in health and social care systems, as well as the scarcity of existing knowledge syntheses. The framework developed by Arksey and O’Malley will be followed that entails six steps: (1) identifying the research question(s), (2) searching for relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising and reporting the results and (6) and conducting consultation exercises. These steps will be conducted iteratively and reflexively, making adjustments and repetitions when appropriate to make sure the literature has been covered as comprehensively as possible. To ensure comprehensiveness of our literature review, we also search a wide range of sources.Ethics and disseminationAn integrated knowledge translation strategy will be pursued by engaging our knowledge users through all stages of the review. We will organise two workshops or policy roundtables/policy dialogues in Alberta and British Columbia with participation of diverse knowledge users to discuss and interpret the findings of our review and to draw out policy opportunities and lessons that can be applied to the context of these two provinces.

“Scallywag battalions”: reflective practice groups with multidisciplinary teams in mental health and social care systems

2019 ◽  
Vol 19 (2) ◽  
pp. 168-185
Author(s):  
John Adlam
Keyword(s):  
Mental Health ◽  
Reflective Practice ◽  
Social Care ◽  
Multidisciplinary Teams ◽  
Practice Group ◽  
Wilfred Bion ◽  
Health And Social Care ◽  
Wide Range ◽  
Care Systems ◽  
The Individual

“Reflective practice” is a term imprecisely understood and used to describe a wide range of different activities or interventions. In this article I examine the Reflective Practice Group (RPG) as an intervention offered to multidisciplinary teams (MDTs) in mental health and social care settings. Drawing extensively upon the work of Wilfred Bion and on the “Northfield I” experiment which he led in 1942, I formulate the existential, conceptual, and functional challenges of the MDT in terms of the problematic interplay between the drive towards autonomy and the exigencies of interdependence. I take this interplay as the figure, with the ground being the baseline disarray of traumatised systems that both defines and contextualises the individual worker’s predicament within the team. Analysing the nature of the MDT sheds new light on longstanding controversies about what ailment the RPG is there to address; what skill set is needed to facilitate it; and what methodology may be most appropriately used for its delivery.

scholarly journals Comparing mental health trajectories of four different types of key workers with non-key workers: A 12-month follow-up observational study of 21,874 adults in England during the COVID-19 pandemic

2021 ◽  
Author(s):  
Elise Paul ◽  
Hei Wan Mak ◽  
Daisy Fancourt ◽  
Feifei Bu
Keyword(s):  
Mental Health ◽  
Public Service ◽  
Food Chain ◽  
Social Care ◽  
Anxiety Symptoms ◽  
Healthcare Sector ◽  
Health Trajectories ◽  
Health And Social Care ◽  
Essential Services ◽  
Time Varying Covariates

AbstractBackgroundThere are concerns that key workers may be at a greater risk for psychological distress than non-key workers during the COVID-19 pandemic. However, little research has included key workers outside of the healthcare sector or has disaggregated key workers into different subgroups.AimsTo examine longitudinal changes in mental health over 12 months during the COVID-19 pandemic comparing four different groups of key workers with non-key workers.MethodLongitudinal data were from 21,874 adults living in England (21 March 2020 to 22 February 2021). Latent growth modelling (LGM) was utilised to compare growth trajectories of depressive and anxiety symptoms in non-key workers and four types of key workers: i) health and social care workers, ii) teachers and childcare workers, iii) public service workers, and iv) essential services key workers (e.g., food chain or utility workers).ResultsWhen accounting for both time-invariant and time-varying covariates, key workers in the essential services category had consistently higher levels of depressive and anxiety symptoms than non-key workers across the whole of the study period. There was little difference in mental health trajectories between health/social care, teachers/childcare and public service worker categories and non-key workers.ConclusionsOur findings suggest risk for poorer mental health during the COVID-19 pandemic varies within the broad category of key workers generally, and that those working in utility, food chain, and transport roles are especially at risk. Future research should focus on identifying which aspects of working conditions may be contributing to occupational stress in these groups.

Future Development of Medical Informatics from the Viewpoint of Health Telematics

2009 ◽  
Vol 48 (01) ◽  
pp. 55-61 ◽  
Author(s):  
K. P. Pfeiffer
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Information And Communication Technology ◽  
Medical Informatics ◽  
Communication Technology ◽  
Social Care ◽  
Care Process ◽  
Health And Social Care ◽  
Care Systems ◽  
Information And Communication

Summary Objectives: The transformation process of the health care systems in most countries in direction of integrated care needs the support of information and communication technology. The central element of this development is the electronic health care record. But there are many other applications around this record and the functionality and usability of these systems has to be improved and extended. Methods: A system-analytic approach to integrated care is used to analyze the possibilities and the role of information and communication technology in current and future health and social care systems. Results: The key elements of the improvements in the next years are the integration of evidence-based knowledge in the care process, the improvement of the usability for patients and health care providers, the development of pro-active systems for decision support, the support of the mobility of patients and the activities of daily living, the integration of data form molecular biology, semantic interoperability and last but not least the processing and analysis of these data. In a series of tables requirements of the functionality of eHealth applications are summarized. Conclusion: Research in medical informatics has to focus on strategic concepts and how to transform the demands of a modern integrated health and social care system into user-friendly, secure and efficient ICT solutions and to support the citizen’s responsibility for her/his own healthcare. But there is also a high demand for research to improve the technology of ICT systems in health and social care.

scholarly journals Can health and social care integration make long-term progress? Findings from key informant surveys of the integration Pioneers in England

2019 ◽  
Vol 28 (1) ◽  
pp. 14-26
Author(s):  
Bob Erens ◽  
Gerald Wistow ◽  
Nicholas Mays ◽  
Tommaso Manacorda ◽  
Nick Douglas ◽  
...  
Keyword(s):  
Integrated Care ◽  
Large Scale ◽  
Social Care ◽  
Community Health Services ◽  
Content Type ◽  
Barriers To Change ◽  
Health And Social Care ◽  
Wide Range ◽  
Key Informant ◽  
Care Systems

Purpose All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and community health services, and involve local authorities and the voluntary sector. ICSs build on previous pilots, including the Integrated Care Pioneers in 25 areas from November 2013 to March 2018. This analysis tracks the Pioneers’ self-reported progress, and the facilitators and barriers to improve service coordination over three years, longer than previous evaluations in England. The paper aims to discuss these issues. Design/methodology/approach Annual online key informant (KI) surveys, 2016–2018, are used for this study. Findings By the fourth year of the programme (2017), KIs had shifted from reporting plans to implementation of a wide range of initiatives. In 2018, informants reported fewer “significant” barriers to change than previously. While some progress in achieving local integration objectives was evident, it was also clear that progress can take considerable time. In parallel, there appears to have been a move away from aspects of personalised care associated with user control, perhaps in part because the emphasis of national objectives has shifted towards establishing large-scale ICSs with a particular focus on organisational fragmentation within the NHS. Research limitations/implications Because these are self-reports of changes, they cannot be objectively verified. Later stages of the evaluation will look at changes in outcomes and user experiences. Originality/value The current study shows clearly that the benefits of integrating health and social care are unlikely to be apparent for several years, and expectations of policy makers to see rapid improvements in care and outcomes are likely to be unrealistic.

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